Fast Finder:
Related Links
WorkSTAR: E-Forms
Outpatient Occupational Rehabilitation
Outpatient Occupational Rehabilitation
Click on a link to open file. Print for your convenience.
For new patients: Intake paperwork
- STARS MR-187: Financial & Privacy Policies
- STARS MR-186: Attendance & Cancellation Agreement
- STARS MR-137: Protected Health Information/ Communication Log Sheet
- STARS MR-183: Patient Profile (Work Hardening/ Work Conditioning Only)
- STARS MR-239: Patient Profile (Functional Capacity Assessment Only)
- B-193: Patient Rights & Responsibilities
- B-378: Notice of Privacy Practices
**For forms in Spanish, please contact our office.
For new patients: Testing Forms
- STARS MR-118: Back School Pre-Test
- STARS MR-121: BECK Inventory
- STARS MR-124: Pain & Impairment Relationship Scale
- DASS: Depression, Anxiety, Stress Scale (DASS for Work Conditioning clients only)
 |
Download
a WorkSTAR map (near Saint Alphonsus Regional Medical Center off of Emerald Street) |
Health Assessment
Pain 101
Pain
can have many causes. Thankfully, many treatments can help.
